Provider Demographics
NPI:1740094721
Name:ROTHKOPF, NECHAMA (PMHNP)
Entity type:Individual
Prefix:
First Name:NECHAMA
Middle Name:
Last Name:ROTHKOPF
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25881 GREENFIELD RD APT 32
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-2112
Mailing Address - Country:US
Mailing Address - Phone:732-691-8651
Mailing Address - Fax:
Practice Address - Street 1:25881 GREENFIELD RD APT 32
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-2112
Practice Address - Country:US
Practice Address - Phone:732-691-8651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-01
Last Update Date:2025-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704414184363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health